Healthcare Provider Details

I. General information

NPI: 1578584595
Provider Name (Legal Business Name): HENRI JOSEPH ROCA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9160 CLAYTON RD
SAINT LOUIS MO
63124-1874
US

IV. Provider business mailing address

9160 CLAYTON RD
SAINT LOUIS MO
63124-1874
US

V. Phone/Fax

Practice location:
  • Phone: 314-801-8898
  • Fax:
Mailing address:
  • Phone: 314-801-8898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number14034R
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number2023041655
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: